‘Looking for answers, and there are none’


Meet our roundtable participants

Carla Money, Springfield

Bill Metcalf, Springfield

Lori Fields, Hamilton

Jason Fields, Hamilton

Jim Pagliaroli, Dayton

Kendra Pagliaroli, Dayton

Shelly King, West Carrollton

Allen Sauner, Dayton

Moderator: Tell us what made you want to be part of the panel.

Bill Metcalf: I've worked construction and blue-collar jobs most of my life, and anymore the employer-sponsored health insurance takes a fourth of your payheck. It's outrageous. Do you pay in on the chance that, if you get sick, you'll have coverage? Or do you invest the money so that if you do get sick, you'll have extra money to pay your bills? That was my thinking until the bottom fell out of the stock market and my savings went down the drain. I tried to get on the Ohio Medical Card; I've got a handicapped daughter, I had a heart attack eight years ago — and now I'm just living on borrowed time.

Carla Money: I am 50, disabled, and a widow. I am not drawing Social Security and I do not have any health insurance. I currently am living on less than $1,000 a month disability insurance from my former employer, Assurant. In March 2007, I experienced an episode in which I simply did not wake up. My heart quit beating and I quit breathing. I "coded" as many as four times in the two weeks I was in a coma. This left me with an anoxic brain injury (lack of oxygen), which means I sometimes cannot find my words, I get lost in my hometown where I have lived my entire life, I misspell the simplest of words, I cannot stand any kind of stress. My list goes on and on. While I was in the hospital, I had excellent health insurance. It continued for six months at no cost to me; then I went from short-term disability to long-term disability and I had to start paying a small premium of $72 a month. After another six months, I was terminated from my employment and COBRA kicked in. I was really worried about what that would do to my insurance premiums but, to my surprise, they only went up by a few cents; but it also only lasted 18 months. As the time was running out on my insurance, I began to check into other plans. The cheapest insurance I could find was $986 a month. That is more than I draw a month. I currently am paying more than $225 a month for prescription medications. I pay full-price for visits to the doctor's office and to a specialist that can be as much as $150 for an office call. If I did not live with my boyfriend, Bill, I would have to choose between my medical care and eating.

Allen Sauner: I'm unemployed and don't have insurance. A while back, I was in a side-impact accident with a semi that injured my hip and shoulder. Also, I'm medically disabled because I have a rare form of narcolepsy, cataplexy, that causes me to black out, collapse, sleepwalk — and I can't sleep for 80, 90 hours at a time, then I'll sleep for two or three hours. Most people who have this die in their 30s or 40s. There's no treatment, and most doctors don't really understand it very well. I can work, but only under certain conditions. But really, part of your brain doesn't work right.

Kendra Pagliaroli: I was taught growing up that having health insurance was equivalent to having car insurance; it's just something a person must have. Me and my husband have purchased our own health insurance since 1997. Since that date we have spent almost $118,000 out of pocket. We both work at a restaurant, and we don't make a lot of money. But we work. We have an 18-year-old daughter, who we've never taken on vacation. I never had a wedding or a honeymoon. I have not had any home repairs to my home since I moved here in 1996. All of our cars have over 100,000 miles because we cannot afford a new or newer model. Why is this? Having health insurance has cost us 30 to 40 percent of our gross pay every year. There is no extra money for anything. Should we live without health insurance? If we have that dreaded heart attack, we might lose everything. We would like to start living our lives and have a little cash left over each week … maybe to save for retirement.

Moderator: So you feel you can't drop the insurance?

Kendra Pagliaroli: No, especially not now. During the past five years, I have been diagnosed with melanoma three times and just last week had genetic testing to see if I carry a melanoma/pancreatic gene. I am only 46. We're waiting to learn the results of the test. I'm glad I have a job and can get up and walk every day. But we have no insurance through our jobs, so we pay for it.

Jim Pagliaroli: You have to wonder why the U.S., the most powerful nation in the world, has one of the worst health care systems.

Shelly King: I am 42, a mother of two young children. In August 2012, I lost my job of 13 years and then in September 2012 my divorce was final. This left me with no health care. I could not afford COBRA, and the cost of health insurance is ridiculous. After losing my job, I started back to school at Sinclair Community College after more than 20 years, trying to better myself, so that I could do better for my kids and myself. I am now collecting unemployment, but I've had a hard time getting it started. I'm going to school full time, and raising my kids with not much help from elsewhere. I have pre-existing health conditions — fibromyalgia, migraines, arthritis and back trouble from factory work 10 years ago. I need medicine, but have you priced some of these medicines without medical and prescription coverages? I've had to scrape to keep a car to get to work and take my son to school. I'm fuming right now. I'm not a political person — I'm not into it. But I'm just trying to keep a roof over my kids' heads, and I can't get any help.

Lori Fields: We live in Hamilton, at least temporarily, as my husband and I lost our home in West Virginia to foreclosure, and we are living with my mother until we can regroup and get back on our own footing. Up until December 2006, we were living in Arizona, with good jobs and good health insurance. Then my husband's father passed away, and he felt obligated to move back to West Virginia to care for his mother and sister, who were both in poor health. With very little available in the way of any — let alone gainful — employment, and even less that offered any benefits, we found ourselves with no health insurance almost immediately. My husband was able to get a substitute teaching certificate after a year and a half, and did substitute teach, but there are no benefits unless the sub position is considered long term. He did get that long-term slot his second year and did get insurance through the board of education, but it covered so little, it barely met the definition of health insurance, in my opinion. … We have not had any health insurance for over three years now. I have a back injury and have applied for Social Security disability, and I'm now in the appeals process. We, of course, do not qualify for Medicaid, even short term, because we are neither 65 years old, nor do we have any children. In addition to my back injury, I am diabetic, asthmatic, and have high blood pressure. Even though my basic meds are inexpensive (on the $4 lists), I have a few that are not. My asthma medicine, for example, runs $135 monthly. My husband has major dental issues that need to be tended to as soon as possible.

Moderator: So what about the government response to this issue?

Metcalf: What's the government solution? COBRA — the most idiotic thing in the world. You've got no job, and your insurance will cost three times more than anything in the world. Brilliant.

Kendra Pagliaroli: I wonder what Obamacare will do for us? I've asked the people at Job and Family Services, and they don't know anything. They say, we're also on a learning curve with it.

Metcalf: I don't trust the government to have our best interest.

Jim Pagliaroli: We're just regular folks. We're looking for answers, and there are none.

Kendra Pagliaroli: Canada has health care — why can't we have it here?

Jim Pagliaroli: We can invade Iraq to throw out a dictator, but we can't help our people here?

Lori Fields: I've noticed most of the people squawking over Obamacare have insurance already. It's like, we have ours — to hell with you.

Jim Pagliaroli: For one medical plan we applied for, we were told we didn't qualify by family size, since it was just us and one child. They said, have another child and you'll qualify. We weren't doing that.

Money: You could've cheated. You could have said you left your wife, and then you and the baby would be eligible.

Kendra Pagliaroli: That's the thing. You lay in bed and think of these idiotic, wild schemes that come into your head. Maybe I should leave him? Divorce him? That may work.

King: Well, I have unemployment, but I have no house — just an apartment with two kids. I can't get anything. The money in my bank account is to pay my rent, so really I have nothing in my account. My kids are insured through their dad's insurance since he works for the state, but I can't get health insurance.

Moderator: So you all deal with a lot of bureaucratic red tape?

Sauner: It's even worse if you're a single male. Nobody helps you, then.

Kendra Pagliaroli: I tell people they just can't wrap their heads around it. My close family, even — I tell them how much I've spent out of pocket, and they just don't believe it.

Moderator: Do you all have problems finding doctors?

Money: It's unreal. First thing they ask is, who's your insurance? If you don't have it, they say aren't accepting people without it.

Lori Fields: We haven't had a doctor since we've lived in Ohio, and I dread the day we'll need one. If it isn't an emergency, we drive three hours back to our doctor in West Virginia, because we just love him, and he'll do whatever he can to help us, give his prescription medicine if he's got it. I don't know what we'll get here, plus I'm not sure anyone will take us.

Sauner: Everything now is about making a profit. It's not about investing to make a better society.

Metcalf: I was reading Forbes in the doctor's office, and they had the list of the top 500 CEOs. Do you know how many of those SOBs were from medical companies? And the bonuses they vote for themselves every year? Where's the money coming from for their big salaries? From the people who pay for insurance. But if something comes up? Then they're just a bunch of Scrooges. Pre-existing conditions, all the off-the-wall rules.

Lori Fields: When we had Jason's insurance when he was teaching in West Virginia, he went to see about bariatric surgery, and we were told that it was almost never approved.

Sauner: It's a legal scam.

Metcalf: And doctors and hospitals will negotiate with insurance companies, but not with individuals.

Moderator: What do you think should be done?

Metcalf: Tax the 1 percent that's living high on the hog.

Money: I would socialize medicine.

Metcalf: Oh God! Not in this country. People here are so scared of that word. Better dead than Red. I think we need to rein in the insurance companies and regulate them to within an inch of their existence.

Jim Pagliaroli: What would fix this? Where would you even begin?

Kendra Pagliaroli: I just wish there was affordable health care for everyone, that's all.

Jason Fields: When they were discussing this, I really hoped they'd come up with a single-payer system so the insurance companies would be out of luck.

Metcalf: At least Obama's trying to do something. Clinton tried, got nothing. Bush didn't even talk about it. Obama said, here's my idea, and all the sudden the Republicans had a plan — just to counter him. It's good he got it through, but I'm not confident.

Moderator: What do you think this current health care situation means for your overall life expectancy?

Metcalf: It'll knock at least 20 years off my life. Without the medicine I should have, I'm lucky to be alive. It's probably just because I'm pretty active.

Money: When I go to sleep tonight, I might not wake up in the morning. I haven't seen my heart doctor in four, five years.

Sauner: I don't expect to see an improvement in my condition. I welcome death. Even if I could get some kind of workable treatment, pills just reduce the quality of my life. I've been taking herbs and being my own doctor for years, pretty much.

Jim Pagliaroli: I've got high blood pressure and high cholesterol, but lots of people do. I mostly worry about my wife.

Kendra Pagliaroli: The stress is killing me, what we pay. Something's got to be done about it. The cost goes up and up. We have no life insurance. If Jim dies, he's out in the back yard.

Jim Pagliaroli: It's like Russian roulette.

King: If my kids get sick, they're taken care of. But if it's me, nothing. I have to stay healthy for my kids.

Lori Fields: I feel like I'm sitting here waiting to die. Nobody wants or has the means to help us out.

Jason Fields: And it's a shame. I'm sorry you feel that way. It'd be cheaper if I croak.

Metcalf: Croaking isn't that cheap anymore, either.

Sauner: I don't think any of this will get fixed until it all just collapses, and they have to start it all over from scratch.

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